Public-private mix for tuberculosis care and prevention. What progress? What prospects?

BACKGROUND: Public-private mix (PPM) for tuberculosis (TB) care implies working with all relevant public and private health care providers to ensure that high-quality TB care is offered to all who need it. Despite significant global progress in PPM expansion and in TB control in general, a large proportion of care providers in high-incidence countries remain unengaged, and one third of the estimated TB cases go unnotified or undetected.

OBJECTIVE: To present a global perspective on the progress and prospects of expanding PPM for TB care and prevention.

DISCUSSION: People with TB in high-incidence countries approach diverse care providers. Productive working collaborations between national TB programmes and other care providers have been scaled up in many countries. However, a large proportion of private providers still do not participate in collaboration or follow recommended TB management practices. Persisting challenges include weak commitment and capacity to work together within both public and private sectors, poor enforcement of essential regulations and inadequate investments.

CONCLUSION: Scaling up PPM programmes is critical to ending the TB epidemic. Investing in implementing bold policies that harness public and private sector capacity, combine collaborative and regulatory approaches and promote modern digital tools to simplify care delivery is the logical way forward.